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Biomedical subjects

Lina Carvalho

Publications and source records attributed to Lina Carvalho.

15 recordsLinked to original sources

[Angiogenesis and cancer: from biopathology to therapy].

Angiogenesis is an important factor in the development of epithelial neoplasias and is useful in the study of progression and metastasis. Neoplastic cells produce angiogenic factors that overtake the antiangiogenic capacity of autoimmune cells. The vascular endothelial growth factor (VEGF) is the most important factor in the neoplastic angiogenesis. In colo-rectal carcinoma the expression of VEGF is parallel with genetic alterations and Duke's grade. In non-small cell lung carcinoma it is possible to define the angiogenic squamous dysplasia that evolves to invasive epidermoid carcinoma. In invasive gastric and lung cancer, the stromal molecules: COX 2, metalloproteinasis and adhesion molecules develop angeogenesis and their validation is important either in and therapy. In breast cancer there is a correlation between the growing of microvessels density, VEGF expression and p53 alterations, pointing to prognosis. Serological values of VEGF may also be used to monitorise the follow up of sarcomas and its reccurrence but vascular metastatic process is not yet completely understood.

Carcinoma, Non-Small-Cell Lung↗

Atypical goblet cell hyperplasia in congenital cystic adenomatoid malformation as a possible preneoplasia for pulmonary adenocarcinoma in childhood: A genetic analysis.

Congenital cystic adenomatoid malformation (CCAM) of the lung is a congenital lesion that is sometimes complicated by bronchioloalveolar adenocarcinoma (BAC). In some cases foci of atypical goblet cell hyperplasia (AGCH) can be found within the cysts. It has been proposed that CCAM and AGCH predispose to the development of BAC. The present study used comparative genomic hybridization (CGH) to screen 22 cases of CCAM (epithelium, surrounding normal lung tissue, and both preneoplastic and neoplastic lesions) for chromosomal imbalances. Of these 22 cases, 10 were CCAM type 1, 10 were type 2, and 2 were type 3. Of the 10 cases of CCAM type 1, 2 were associated with AGCH, 1 was associated with atypical adenomatous hyperplasia (AAH) and associated tubular adenocarcinoma (AC), and 2 were associated with BAC (1 mucinous and 1 predominantly nonmucinous). The present study also involved immunohistochemistry for interleukin (IL)-13, IL-4 receptor-alpha (IL-4r alpha), cytokines involved in the differentiation of goblet cells, and mucin 2 protein (Muc2). Chromosomal aberrations were not detected in the epithelium or the surrounding normal lung tissue, whereas varying aberrations were found in the neoplastic lesions. The most frequent genomic imbalances observed in both AGCH and the carcinomas were gains in chromosomes 2 and 4. Interestingly, a predominance of gains was also reported in AC of nonsmokers. Chromosomal aberrations in AGCHs arising in CCAMs support their preneoplastic status. Nuclear expression of IL-13, IL-4r alpha, and Muc2 was detected in AGCH, whereas a cytoplasmic and nuclear reaction was seen in normal epithelium. This likely reflects an association with goblet cell differentiation, but it also drives proliferation in AGCH.

Adenocarcinoma↗

[Benign metastasizing leiomyomas].

Benign metastasizing leiomyomas are rare tumours of the lung. The presenting symptoms are variable and the patients can be asymptomatic till a routine x-ray of the thorax is made (or at necropsies) and a history of uterine myomectomy is discarded. The mitotic rate is low and no cellular atypia is found but these tumours can be multiple, follow venous growth and be cause of breath inadequacy and death. Therapy has not yet been defined and can go from hysterectomy and ovariectomy to hormonal frenation with LH RH agonists. A case a benign metastasizing leiomyomas in a menopausal woman is described. A revision of literature is done.

Female↗

[DIP (desquamative interstitial pneumonia): as a tobacco-associated disease -- case report].

DIP (desquamative interstitial pneumonia) is an interstitial lung disease with diffuse and uniform accumulation of alveolar macrophages. There is a strong association with tobacco since 90% of the patients are smokers. The interstitial lung diseases related to tobacco are diverse and include tumours, emphysema, chronic bronchitis, RBILD (Respiratory Bronchilites associated Interstitial Lung Disease), DIP and Langerhans Cell Histiocitosis. The authors present a case of DIP. A brief theorycal revision and discussion of a case is made facing the association with tobacco.

Adult↗

[Pleomorphic adenoma of the trachea. Case report].

The authors present a case of a pleomorphic adenoma of the trachea, diagnosed during the clinical evaluation of a suspected COPD or lung cancer in a heavy smoker patient with a positive family history of oncologic diseases. The patient underwent segmental resection of the trachea with complete excision of the tumour, and a good prognosis is anticipated.

Adenoma, Pleomorphic↗

[Lung adenocarcinoma: application of the WHO 1999/2004 classification to the caseload of the Pathologic Anatomy Service at the Hospital of the Coimbra University].

A study of 701 primary adenocarcinomas of the lung was made at the Department of Pathology of the Hospital da Universidade de Coimbra for a period of fifteen years, between 1990 and 2004. In the same period 382 metastases were diagnosed, mainly from colon (119) and breast (66). The incidence of primary adenocarcinomas varied from 16 cases in 1990 to 49 cases in men and from 12 to 37 cases in women in that period. From 2001 onwards, the incidence was almost coincident in both genders. In the last four years, since 2001, patients were in the seventies at the time of diagnosis and a considerable number of cases were diagnosed after 80 years of age. The criteria defined by the WHO classification of Tumours of the Lung, Pleura, Thymus and Heart 2004 were applied to the primary adenocarcinomas of the lung and as was expected, bronchioloalveolar carcinomas had its incidence in women while acinar adenocarcinomas were diagnosed mainly in men. These conclusions were obtained via surgical specimens and when surgical biopsies were representative and those were mainly in stage IIB and IIIA. A number of 109 cases had the final diagnosis of adenocarcinoma of the lung based on morphology and immunohistochemistry criteria.

Adenocarcinoma↗

[Mediastinal angiofolicular lymphoid hyperplasia--Castleman's disease--case report].

Angiofolicular lymphoid hyperplasia was first described by Castleman as a lymph node hyperplasia characterized by abnormal follicles with small germinal centres and high capillary proliferation. The authors present a case of a 37 year old man with thoracalgy and a mediastinal mass of 4 cm diameter, fleshy and red with a white central area. The diagnosis of plasma cell type of angiofolicular lymphoid hyperplasia in an mediastinal lymph node was made. He also had involvement of two "diaphragmatic" lymph nodes. Angiofolicular lymphoid hyperplasia--Castleman's disease--is a rare lymphoproliferative disease that involves the mediastine or the pulmonary hilus when of solitary form but it can also have other localizations (multicentric or systemic form). Two histological variants are described, the hyaline vascular type and the plasma cell type. IL-6 seems to be in the plasma cell type, due to plasma cells proliferation. Castleman's Disease must be considered in the differential diagnosis of mediastinal masses, namely lymphomas.

Adult↗

[Glomic tumor: presentation of an infrequent case].

Glomic tumours are perivascular tumours whose cells resemble modified smooth muscular cells of the glomic body. They are more frequent in the subungueal region and rare in the lung. The authors present a case of a 62 year old women with left thoracic pain and great enforces dyspnoea. She presented a solitary nodule in the external basal segment of the LLL, 1.9 cm diameter, circumscribed, firm and with nodular whitish rose cut surface. Glomic tumours are generally benign. They may origin in ectopic glomic cells or be differentiated from non glomic cells. They should be classified as glomic tumor, glomangioma and glomangiomioma according to the relative abundance of glomic cells and of the vascular and muscular components. Pulmonary metastasis of malignant glomic tumours have been described. In these cases an extra pulmonary primary origin must be excluded. The differential diagnosis of glomic tumours of the lung includes the carcinoid, hemangioperycitoma, smooth muscle tumours (epithelioid leyomioma) and the paraganglioma.

Female↗

[Epithelioid haemangioendothelioma of the pleura: 29 months survival].

Epithelioid haemangioendothelioma of the pleura is a rare neoplasia with a very poor prognosis due to aggressive involvement of the pleura and incomplete surgical treatment. Histological diagnosis and imagiology is also controversial, related to discrete development of the lesions that later reveal nodules. In 2005 there were 31 cases of vascular tumours described in the pleura. Eleven were epithelioid haemangioendotheliomas. This is another case, a 52 year old woman who suffered a traumatism and died 29 months after the histological diagnosis because CAT revealed discrete pleural involvement and a 2 cm nodule was seen only one month before death.

Female↗

[Broncho-pulmonary adenomas].

Adenomas of solitary gland type together with papillomas are the true benign tumours in or around the bronchial tree. Alveolar adenoma and papillary adenoma are more frequently observed in peripheral parenchime although this group of tumours is very rare and often incidentally diagnosed. Presenting usually as solitary nodules in adults after 45 years, are easily recognized because of distinct morphology but alveolar adenomas may be difficult to evaluate in frozen sections. Two cases of pleomorphic adenoma and alveolar adenoma are presented and a review of literature is made.

Adenoma↗

[Morphological features of the pulmonary sequestration].

The pulmonary sequestration corresponds to pulmonary tissue intra or extra-lobar with systemic arterial nutrition and collateral bronchial ramification. It is infrequent and the intra-lobar identification depends on the correct clinical signs and morphology. The correct study includes imagiologic identification of the systemic artery and morphological characterization of parenchymal changes. These allow identification of abnormal pulmonary parenchyma in intra-lobar cases and were observed using histochemical and immunohistochemical routine methods, both in intra and extra-lobar cases. Four cases of intra-lobar sequestration and four cases of extra-lobar sequestration were studied with application of histochemical techniques--Movat's pentachrome stain and Verhoeff--and immunolabelling with CK7 and TTF1. The parenchymal inflammatory distortion by collagenization was constantly seen as was BALT hyperplasia and pleuritis. By using Movat's pentachrome stain we characterized the sequestration by identifying the artery and the parenchymal changes. The CK7 was useful in the identification of parenchymal damage, together with the antibody anti-TTF1 that had a variable expression, stronger in areas of inflammation because of PII hyperplasia.

Adolescent↗

[Congenital cystic adenomatoid malformation of the lung or congenital pulmonary airway malformation].

The cystic adenomatoid malformation of the lung is an hamartomatous lesion, easily identifiable by its morphology through the application of Stocker's et al (1977) classification (type 1, 2 and 3) and also following the criteria of Yousem, to understand the five types dependent on the level of malformation in the airway and lung. The three morphological types described by Stocker were identified in 6 cases of the archive of the Department of Pathology of Coimbra's University Hospital, studied morphologically by the use of Movat's pentachromic stain and the application of the antibody anti-CK7 and anti-body anti-TTF1. In the three morphological types the elastic alveolar net is absent. The CK7 identifies the epithelial distribution and is useful to evaluate the extension of the inflammatory lesion. The antibody anti-TTF1, apparently absent in type 3 cases, is easily identified in type 1 and 2 cases and overexpressed in inflammatory areas. It seems that the absence of cells identified by the antibody anti-TTF1 prevents overdiagnosing of type 4 in Yousem's classification of congenital pulmonary airway malformation (CPAM).

Adolescent↗

[Pulmonary hamartoma].

The so-called pulmonary hamartomas occur in 0.3% of the general population, with a higher frequency in male gender and in the sixth decade of life. Usually they are single lesions peripherally located in the lung, are formed by mature lobular cartilage and less frequently show adipous and fibromixoid tissue, also with calcified foci. These tumors should be called benign mesenchymomas, due to studies that showed cromossomic alterations and genetic translocations, whose malignant potential has not been recognized.

Adult↗